If a field is not applicable please fill in n/a and for phone numbers that are not applicable fill in (000)000-0000
(This card needs to be completed every school year and for each child)
If my child needs to be taken to an emergency facility, he/she will be taken to the nearest one, to assure prompt attention to your child.
PLEASE NOTIFY SCHOOL OF ANY CHANGE IN PHONE NUMBER OR ADDRESS.
Please complete the requested information below to participate in our automated messaging system managed by One Call Now (OCN). This messaging system will be used to communicate important information and updates regarding emergency situations (lockdowns, tsunami, and other natural disasters), school cancellations, bus scheduling, huakaʻi reminders, meetings and school activities.
Your participation is highly recommended. All names and phone numbers will be held in the strict confidentiality and will only be used for school purposes. Contact information can be updated at your convenience and you may cancel participation at any time. Please complete one letter per ʻohana and return to kumu. If you have further questions regarding this service please call Kelly Osorio at Ka ʻUmeke Kāʻeo at (808) 961- 0470 ext. 222.
Helu Kelepona Primary contact phone number for all notifications (e.g. announcements, reminders notifications)Hale:Phone Number* Primary Number Text Emergency Only (Home)Makuahine Kelula:Phone Number* Primary Number Text Emergency Only (Mom Cell)Makuakāne Kelula:Phone Number* Primary Number Text Emergency Only (Dad Cell)Helu ʻē aʻe: Phone Number* Primary Number Text Emergency Only (Other)
1. Users are responsible for their account(s). Users should make appropriate use of the system and network-provided protection features and take precautions against others obtaining access to their computer resources. Individual password security is the responsibility of each user.
2. Users are forbidden from using techniques designed to cause damage to, deny access by legitimate users of computers or network components connected to the Internet or result in the loss of the recipient's work.
3. Users shall not use another user's account or password without proper authorization. 4. Users are forbidden from circumventing security measures on school or remote computers and networks.
5. Users shall not download, install or run security programs or utilities which reveal weaknesses in the security of a system. For example, the users shall not run password cracking programs on any of the Department's computing systems.
6. Users are prohibited from sending unsolicited, commercial and/or offensive e-mail. 7. Users are prohibited from using any form of electronic media to harass, intimidate or otherwise annoy another person/group.
8. Users shall not make copies of system configuration files for their own unauthorized personal use or to provide to other people/users with unauthorized uses.
9. Users may post pages that are consistent with the public, non-profit educational mission of the Department of Education and are in compliance with all state and federal laws, including those prohibiting obscenity, defamation or copyright infringement.
10. Use of the Department of Education network resources to illegally distribute or duplicate unauthorized copyrighted or licensed material is prohibited.
11. Use of the Department of Education network to post, send, or retrieve pornographic material, inappropriate text or graphic files, or files dangerous to the integrity of the network are prohibited.
12. Use of the Department of Education network system in a manner that encumbers system and network resources to the point that usage causes interference with others' services is prohibited.
13. The Department of Education network and computing resources shall not be used for political lobbying.
14. The Department of Education is a non-commercial user of the web and use of the web must remain non-commercial. No personal money-making activity may be conducted through the use of the Department's computing and networking resources.
15. The Department of Education is not responsible or liable for materials in violation. Users are responsible for the content of their postings and obtaining all necessary permissions or licenses for any material used.
16. Users shall not make unauthorized copies of copyrighted software, except as permitted by law or by the owner of the copyright.
17. Sending or receiving unlawful information via electronic communications; using electronic communications illegally in ways that violate local, state, federal, or international laws or statutes are prohibited.
18. Users shall always cooperate with requests from the system administrators for information about the users' computing activities.
19. Users are requested to report any weaknesses in the Department of Education's computer security, any incidents of possible misuse or violation of this agreement to the proper authorities by contacting Network Support Services Branch via email: email@example.com.
20. The Department of Education reserves the right to investigate and monitor any accounts, servers, or machines suspected of policy violation.
21. The Department of Education reserves the right to disconnect any device that is the source of malicious or suspicious activities without notice until the machine in violation is cleaned or fixed.
22. The Department of Education reserves the right without notice to freeze and delete an account that is engaging in activities that violate the Department of Education's policy or the source of spamming, abusive or malicious activities.
I, Students First & Last Name*, along with, Parent First & Last Name* agree to the terms and conditions of the acceptable use guidelines.
The information you provide above will determine what services you or your child may be eligible to receive under the McKinney- Vento Homeless Assistance Act - 42 U.S.C. $11434a(2) If eligible under the Act, you or your child are entitled to immediate enrollment in school and free school meals. Transportation may be provided to and from school of origin. This questionnaire allows a Homeless Concerns Liaison to contact you for additional support. By signing, you grant permission to share/release pertinent information among shelter and school personnel, to support school enrollment and full participation.
My (our) child First & Last Name* in papa
* has my consent to attend and participate in all huaka'i activities connected with his/her being a student at Ka 'Umeke Kā'eo (K'UK) Public Charter School. My child has permission to travel by K'UK bus, public carriers, chartered bus, K'UK vans, private or commercial vehicles driven by an adult representative, or walk with adult supervision for all huaka'i purposes.I expressly waive and release any and all claims against the Department of Education of the State of Hawai'i, Ka 'Umeke Kã'eo Public Charter School, and any duly appointed representatives on account of accident, injury or illness that may be incurred by my child while participating in any activity; including but notlimited to travel and huaka'i as referred herein.You will be kept abreast of all huaka'i schedules, waivers, and needed supplies through your child's kumu and the K'UK ke'ena. Huka'i at K'UK are a substantial part of our curriculum and participation by all students in all activities is important for learning. Your child will be required to participate in all huaka'i activities unless otherwise specified through submitting in writing to your child's kumu their name, activity, and date of non-participation.In case of illness or injury to said child/student, we (I) hereby consent to and authorize such medical or dental treatment as deemed necessary, and agree to pay such medical and dental costs if incurred. We will make every effort to contact you before such action is taken.
We (I) the undersigned and their heirs and assigns agree to assume all responsibility for injury or other liability in connection with the use of All Properties under the Stewardship of the Edith Kanaka'ole Foundation by said minor(s) and authorized accompanying persons and agree to indemnify and hold harmless the Edith Kanaka'ole Foundation, its agents, and employees and their heirs, successors and assigns from any claims, demands, or other liability arising out of the use of All Properties under the Stewardship of the Edith Kanaka'ole Foundation pursuant to Article XII section 1 of the Edith Kanaka' ole Foundation by-laws by said minor(s) and authorized persons accompanying said minor(s).
E ‘olu‘olu, e kaomi i kēia loulou a ho‘opihapiha i ka ho‘oku‘u kuleana pūnaewele no Hui Ho‘oleimaluō. (Please click on this link and fill out the online liability form for Hui Ho‘oleimaluō.)
No ka makahiki kula, e koho i ka mea ‘ē a‘e: a e kikokiko iā 2023-2024. A laila e koho i nā wahi a pau (Honokea Loko, Waiuli a me
Kaumaui). (Select school year 2023-2024 (under Other). Also, select all sites (Honokea Loko, Waiuli and Kaumaui).
Kamehameha Schools (KS) strives to provide activities in safe learning environments that minimize potential dangers. However, there are certain inherent risks associated with every activity. These activities may include, but are not limited to, environmental clean-up activities, building pā pōhaku, hiking, swimming invasive eradication, gathering and native habitat restoration, ‘āina-based learning activities in ocean, ponds, stream, or other water sites, and canoe activities. If you determine that you and/or your child is able to participate in the activities and determine for either yourself(ves) and/or your child the risks associated with the activities are acceptable to you, complete this form and return it to Ka ʻUmeke
In consideration for my or my/our child’s participation in activities held at KS properties and at properties owned, leased or managed by affiliates or subsidiaries of KS, and on behalf of myself/ourselves, my/our personal representatives, heirs, assigns, and child, (a) I/we waive and release any and all claims against KS, its Trustees, officers, directors, agents representatives and employees, in both their personal and professional capacities, its subsidiaries, affiliates, partners and agents, and their respective officers, directors, agents, representatives and employees, in both their personal and professional capacities (collectively also “KS” and/or “Released Parties”), for injuries, liabilities, losses or damages connected with or arising out of my or my/our child’s participation in the activities, or rendering of any medical treatment, to myself or my/our child; and (b) I/we agree to indemnify, defend and forever hold harmless, KS from and against any and all claims, proceedings, injuries, liabilities, losses, damages, and expenses including reasonable attorneys’ fees and cost, relating to my or my/our child’s participation in the program arising out of or relating to my or my/our child’s participation in activities held at KS properties and at properties owned, leased or managed by affiliates or subsidiaries of KS.
I/We understand that activities I or my/our child may participate in may be covered by the Hawai‘i Recreational statute (HRS Chapter 520) and, if so, this waiver will apply only to the extent it may provide broader protections and a broader release to the Released Parties.
I/We agree that I/we assume full responsibility for any injury or damage to myself or my/our child or other person’s or property that I or my/our child may cause arising out of or relating to my/our or my/our child’s participation in activities held at KS properties and at properties owned, leased or managed by affiliates or subsidiaries of KS.
I/We also hereby give permission to Released Parties to take me or my/our child to a doctor, dentist and/or emergency medical facility in any vehicle as Released Parties deem appropriate. 1 I/We also hereby give permission to film, tape, or otherwise record my or my/our child’s name, voice and person. I/We understand that these recordings may include, but are not limited to, news releases, photographs, media releases, open- circuit (broadcast), closed circuit, and/or cable television transmission within or outside of the State of Hawaii in perpetuity. I/We waive any right to approve any recording; and I/we understand that there is no obligation by the Released Parties to use any recording. I/We also understand that there will be no financial or other remuneration for any recording, either for initial or subsequent transmission or playback.
I/We hereby certify that the above information is true to the best of my/our knowledge and agree to furnish proof and other documentation as requested. I/We acknowledge that failure to disclose any requested information, or providing inaccurate, incomplete and/or false or misleading information, may result in my or my/our child’s participation in activity/event.
Select Days Needing Transportation:
Select point of drop off & pick up:
I have read and understand the rules of the bus. I further understand that failure to follow the rules will result in dismissal from bus service. Signature* (please initial)
Hawaiian Immersion Public Charter School
Dear Faculty, Staff, and Parents/Guardians:
In 1986, Congress passed the Asbestos Hazard Emergency Response Act (AHERA) mandated the Asbestos-Containing Materials in Schools Rule, 40 CFR Pert 763, which requires all primary and secondary school buildings to be inspected by AHERA accredited inspectors and to identify all asbestos containing building materials. The rule further requires the development of a management plan by AHERA accredited management planner that is based on the findings of the inspection. The management plan outlines our intent in controlling the potential for exposure to asbestos fibers in our school.
In February 2001, the Hawai'i State Legislature adopted Hawai'i Administrative Rules Chapter 11-502. These rules essentially mirror the requirements of AHERA regulations. In both cases, the rule requires our school to notify parents, teachers, and employees of the presence and status of asbestos-containing material in our school buildings.
The initial inspection of our school was conducted a number of years ago and identifies some asbestos-containing materials. Since that time, we continue to conduct periodic surveillances and re-inspections to ensure that the asbestos-containing materials remain in good condition and do not pose a hazard to our students and staff.
An asbestos management plan was drafted based on our initial inspection and submitted to the Hawai'i State Department of Health. It outlines in detail the methods we will use to maintain the material in a safe manner. The management plan is updated regularly as asbestos is removed or conditions change.
A copy of the management plan is on file in the business office and available for your review during regular school hours.
Should you have any questions please call Nohea Nahale-a at 961-0470.